Breast Augmentation - Breast Implants
Breast augmentation is a procedure done to enlarge the breasts using implants. These consist of a shell, made of transparent silicone material, which is filled with either sterile saline solution or with silicone gel. Both can produce fantastic results, and the pros and cons of each will be discussed with you to select the best implant type.
Breast augmentation is now one of the most requested cosmetic procedures and has one of the highest satisfaction rates. No longer a privilege for a wealthy few, or the choice of exotic dancers, actresses, etc., breast augmentation is an affordable option for thousands of women. The reasons for desiring breast augmentation are many but fall under two general categories.
Some women never develop breasts to the degree that makes them feel well proportioned. They often have difficulty fitting into clothes, especially summer clothes and bathing suits. They may seek surgery for the simple reason of filling out their clothes correctly. Some wish to feel more balanced, to match the rest of their figure. Other women come in because they once had breasts that they were happy with but aging, pregnancy, breastfeeding, and weight loss have taken their toll. These women often just want to regain what they lost through these circumstances.
The costs have come down significantly over the years making this option affordable for many women. Most patients are not wealthy or unusually affluent. Financing options are available and can be very convenient. We discourage financing if this will place patients under a severe financial burden. The cost of a breast augmentation is less than spent on a typical vacation, and the results last much, much longer.
At their initial consultation, patients will talk to one of our surgeons who will inquire into their desires and goals. The procedure will be explained in great detail, and this discussion will include explaining how the surgery is done, the various choices to be made as to implant type, incision, size, etc. and the anticipated recovery, and results. Our surgeons have a combined experience of over forty years performing breast augmentation and will be happy to provide information on their individual training and expertise. Many patients have given permission for their pre- and post-operative photographs to be shown for education purposes and we will be happy to show you examples of our work. Risks and complications will be carefully explained so that patients will have all the information they need to make a choice they will be entirely comfortable with. We believe our best patients are those who are most informed.
There are some decisions to be made regarding this surgery. Choice of the incision is one. We generally use an incision along the margin of the areola or underneath the breast. Scars are small, usually no more than an inch, and well hidden. Implants may be placed directly underneath the breast tissue, or under the muscle, the pectoralis muscle, which runs across the upper chest. Each approach has advantages and disadvantages, and the approach that we feel will work best for each patient will be recommended. There are several styles of both saline and gel implants; round ones, smooth ones, tear drop shaped implants and fuzzy ones. We choose the implant that we feel will work best for each situation. We have found that the smooth, round implants work best for most women. All implants are guaranteed by the manufacturer to be free of defects for life.
Sizing of the breasts for implants is usually done during surgery to determine the best size implant for each patient. Patients can also pre-size by putting implants into their bra during their preoperative visit to see what they like. The final determining factor, however, is what the skin and tissues will accept and how the breasts look at surgery. We try our best to get you the perfect breast size for you.
We perform breast augmentation in our dedicated, state-licensed surgical suite. General anesthesia is usually recommended as this is extremely safe and comfortable for patients. Many practices cannot offer this option. The procedure takes about an hour to perform, and patients recover and return home in the care of a responsible adult within a couple of hours. Pain is well controlled by prescription pain medications that patients pick up in advance of the day of surgery so that it will be immediately available to them. Our patients are also given antibiotics to reduce the risk of any infection.
Most patients are up and about the next day and able to resume routine daily activities in a few days. Some patients may return to all activities with no restrictions placed on them within seven days. Several office visits will follow over the next six months to ensure that everything is progressing as it should. Final results are usually seen between three and six months.
Patients wear a comfortable, compression bra or an elastic band after surgery to help the implants settle. These may be recommended for several months after surgery. Patients are instructed on a simple breast massage program, also to aid softening. Vitamin E or other medications may be recommended for some patients for the same reason.
Breast implants do not have a pre-determined life expectancy and may last a lifetime. It is unreasonable to expect any man-made prosthetic device in the body to remain in place for 20, 30, 40, or more years without some risk of failure. Leakage of saline implants is uncommon, is harmless, and is easily corrected with a minor office procedure. We tell patients, especially if they are very young, that they should expect some time in their life to need or desire additional surgery as a result of having breast implants. This may be replacement with a new and better device, removal or exchange of a leaking implant, a breast lift, or replacement with a larger or smaller implant at some later time. The excessive firmness of the breasts as result of scar around the implants is infrequent and, if it occurs, usually will be evident in the first few months after surgery. In some rare cases, this firmness can develop even years later without an apparent cause. Such rigidity, called capsular contracture, may require corrective surgery.
Given each patient's unique characteristics, every effort is made to produce the best possible result for the patient. The goal is breasts that are natural appearing, soft, symmetrical, and of the size desired by the patient. We do not practice “assembly line” or “cookbook” breast surgery and each procedure is individualized to provide the best result under those circumstances. Satisfaction rates for breast augmentation are among the highest in cosmetic surgery and run as high as 95% after ten years or more.
Breast implant surgery is one of the safest cosmetic procedures that we perform but like all surgical procedures it has some inherent risks. These will be discussed with you in detail at the time of your initial consultation. You may also go to Dr. Bosshardt’s blog on this website which describes some of these potential risks. In the same way that we do everything to produce the best result for each patient, we likewise take great pains to be sure that surgery is performed with as much safety as is humanly possible.
Our goal is for every patient to look back on this decision for breast augmentation as one of the best decisions they ever made and one they would do over again if given a chance.